In the treatment of malleolar fracture, anatomical reduction and rigid internal fixation are essential to prevent the complications such as infection, malunion or nonunion, traumatic arthritis, skin necrosis and joint contracture. But it is often difficult to obtain rigid fixation for medial malleolar fracture because of its comminution or thin cortex with osteoporosis. Generally, two operative methods are available for medial malleolar fracture, which are malleolar lag screw fixation and tension band wiring. The purpose of this paper is to analyze which operative method is better for anatomical reduction and rigid fixation and has less postoperative complications for medial malleolar fractures. From March 1992 through March 1995, 88 patients had undergone surgical intervention for medial malleolar fractures. The patients were divided into 2 groups according to operative method for medial malleolar fracture. For one group, malleolar lag screw together with or without a K-wire was used in 48 patients, and for the other group, tension band wiring was used in 40 patients. The average follow-up periods were 14 months in screw fixation group and 13 months in tension band wiring group. The average union time were 15.4 weeks (8-17 weeks) in screw fixation group and 12.2 weeks (6-15 weeks) in tension band wiring group. 27 cases (56%) showed excellent result in screw fixation group and 30 cases (75%) in tension band wiring group. In the patient over 50 years old, 2 (15%) in 13 cases showed excellent result of screw fixation group, while 5 (45%) in 11 cases of tension band wiring group. We concluded that tension band wiring is a better method for medial malleolar fracture to obtain early union and to prevent postoperative complications, especially in the elderly patient.
Aged ; Arthritis ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Middle Aged ; Necrosis ; Osteoporosis ; Postoperative Complications ; Skin

We carried out five common electroretinographies according to the recommendation by the International Society of Clinical Electrophysiology of Vision in the eyes of 40 non-diabetic brach retinal vein occulusion. The clear media, no previous history of photocoagulation and no evidence of neovascularization of the retina and/or iris were criteria for inclusion in this study. The data were compared with those of fellow eyes, expecting that this procedure may provide a new feature that could have some clinical significance. The reduction of the summed amplitude of oscillatory potentials, and the timing delay of the cone response b-wave and 30Hz flicker responses were of most frequent occurrence. hence, the reduction of the summed amplitude of oscillatory potentials and the timing delay of the cone response b-wave and 30Hz flicker responses may be valuable indicators. These abnormalities represent overall inner retinal dysfunction. The cone response b-wave timing was more frequently affected than that of the maximal combined response b-wave. This fact may reflect that an ischemic lesion is located in the vicinity of the posterior pole of the fundus.
Electrophysiology ; Electroretinography ; Iris ; Light Coagulation ; Retina ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde*

No abstract available.
Female ; Mosaicism* ; Ovary*

Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Follow-Up Studies ; Genioplasty* ; Humans ; Jaw ; Male ; Malocclusion ; Osteotomy* ; Paresthesia ; Prognathism*

Although many reports have been published about Legg-Calve-Perthes disease, developmental dysplasia of hip, it is difficult to gain a satisfactory results in treatment. We experienced 9 year-old girl with ipsilateral neglected DDH combined with contralateral LCPD, and treated with Klisic operation for DDH and femoral valgus osteotomy for hinged abduction of LCPD. We gained satisfactory results and report this rare case.
Child ; Female ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Osteotomy

Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual’s ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.

Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual’s ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.

Mn (manganese) is known to induce Parkinsonian neurological disorder. Several lines of evidence suggest that apoptosis is involved not only in physiological cell death during normal development but also in neurodegenerative disease. The mechanism of Mn induced cell death remains poorly understood. In the present study, we evaluated the morphologic changes and apoptotic profile in basal ganglia using rat model of Mn toxicity. The rats were divided into three groups: the first group was a control; the second group was subdivided by administration dosage of Mn into group A (5, 10 mg MnC12/ kg) and group B (20, 40 mg MnC12/kg). The rats of each subgroup received a injection of Mn via tail vein every week for 4 weeks. The second group received 4 repeated injection of 10 mg MnC12/kg in the same manner and the rats were sacrificed at day 1, 3 & 7 in group I and at day 10, 21, 42, and 90 in group II after the last injection. A significant loss of neuron and gliosis were observed in the basal ganglia in the experimental groups (p<0.05), which were more pronounced in group II than in the control or group I. No significant difference in number of nerve cells or degree of gliosis was identified in the substantia nigra. Apoptotic cells were also increased in basal ganglia of experimental groups and appeared among neurons (10%), glial cells (10%), and endothelial cells (60%). Apoptotic figures were consistently noted through the entire experimental period after Mn injection in basal ganglia. In conclusion, these results demonstrate that Mn-induced cytopathic insult affects various cell types in basal ganglia and shows variable sensitivity in the different regions of brain, especially in the apoptotic cell death of the neuron. The overaccumulation of Mn in the brain might be attributed from the breakdown of blood-brain barrier due to the injury through the apoptosis.
Animals ; Apoptosis ; Basal Ganglia* ; Blood-Brain Barrier ; Brain ; Cell Death ; Endothelial Cells ; Gliosis ; Manganese* ; Models, Animal ; Nervous System Diseases ; Neurodegenerative Diseases ; Neuroglia ; Neurons ; Rats* ; Substantia Nigra ; Veins